PGY1 PHARMACY RESIDENCY PROGRAM MANUAL 2017-2018 BETH ISRAEL DEACONESS MEDICAL CENTER BOSTON, MASSACHUSETTS
Pharmacy Practice Residency Manual (2017-18) Table of Contents Program Overview Page Residency Purpose Statement 2 PGY1 Residency Required and Elective Educational Outcomes 2 ASHP Required Competency Areas, Goals, and Objectives 3-4 BIDMC Residency Program Administration 5 BIDMC Residency Advisory Committee (RAC) 6 BIDMC Resident Advisor 6 Resident Staff Mentor 6 BIDMC Residency Program Structure (2017-18) 7 PGYI Residency Program Requirements 8-9 Qualifications of the Resident 10 Application Requirements for BIDMC PGYI Residency 10 Acknowledgement of Residency Match 10 Pharmacy Licensure Verification 11 BIDMC Program Obligations to the Resident 12-13 PGYI Pharmacy Residency Evaluations 13 PGY1 Pharmacy Residency Preceptor Requirements 14 Preceptor Development 15 Expectations and Responsibilities of the Resident Professional Conduct 16 Professional Dress 16 Employee Badges 16 Communication 16 Confidentiality 16 Attendance 16 Duty Hour Policy 17 External Employment Policy (Moonlighting) 17 Resident Disciplinary Action 18 Completion of BIDMC Residency Requirements 19 General Information: Salary/Paid Time Off 20 Benefits 20 Vacation/Personal Days 20 Sick Days/Extended Illness 21 BIDMC Department of Pharmacy Overview 22 Rotation Information: Core Clinical Rotations 23-26 Core Elective Rotations 26 Additional Longitudinal Experiences 27 Residency Project: Residency Project Overview 28 General Project Timeline 29 Project Approval Form 30 Project Completion Documentation Sheet 31 Current and Past Resident Projects 32-33 Resident Continuing Education (CE) Program Guideline: 34 Longitudinal Activities Tracking Grid 35-36 General Residency Timeline 37-38 BIDMC Residency Preceptor Self-Assessment 39-40 DRAFT Schedule and Rotation Template for Residency Program 41 Appendices 44-60
Beth Israel Deaconess Medical Center PGY1 Pharmacy Residency Program 2017-18 Purpose Statement The Post Graduate Year one (PGY1) Pharmacy Residency Program at Beth Israel Deaconess Medical Center (BIDMC) builds upon Doctor of Pharmacy (Pharm.D.) education and outcomes to contribute to the development of clinical pharmacists who are: responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy residency training. PGY1 Program 2017-18 ASHP Required Competency Areas For Postgraduate Year One (PGY1) Pharmacy Residencies R1: Patient Care R2: Advancing Practice and Improving Patient Care R3: Leadership and Management R4: Teaching, Education, and Dissemination of Knowledge E1: Pharmacy Research E5: Management of Medical Emergencies E6: Teaching and Learning BIDMC Additional Required Competencies 2
BIDMC PGY1 Residency Program 2017-18 ASHP Required Competency Areas, Goals, and Objectives For Postgraduate Year One (PGY1) Pharmacy Residencies and Additional BIDMC Competencies Competency Area R1: Patient Care Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process. Objective R1.1.1: Interact effectively with health care teams to manage patients medication therapy. Objective R1.1.2: Interact effectively with patients, family members, and caregivers. Objective R1.1.3: Collect information on which to base safe and effective medication therapy. Objective R1.1.4: Analyze and assess information on which to base safe and effective medication therapy. Objective R1.1.5: Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans). Objective R1.1.6: Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions. Objective R1.1.7: Document direct patient care activities appropriately in the medical record or where appropriate. Objective R1.1.8: Demonstrate responsibility to patients. Goal R1.2: Ensure continuity of care during patient transitions between care settings. Objective R1.2.1: Manage transitions of care effectively. Goal R1.3: Prepare, dispense, and manage medications to support safe and effective drug therapy for patients. Objective R1.3.1: Prepare and dispense medications following best practices and the organization s policies and procedures. Objective R1.3.2: Manage aspects of the medication-use process related to formulary management. Objective R1.3.3: Manage aspects of the medication-use process related to oversight of dispensing. Competency Area R2: Advancing Practice and Improving Patient Care Ideally, objectives R2.1.1-R2.1.5 will be addressed through residents working on one quality improvement or research project; however, if this is not possible, all objectives must be addressed by the end of the residency year and can be addressed through work on more than one initiative. Goal R2.1: Demonstrate ability to manage formulary and medication-use processes, as applicable to the organization. Objective R2.1.1 Prepare a drug class review, monograph, treatment guideline, or protocol. Objective 2.1.2: Participate in a medication-use evaluation. Objective 2.1.3: Identify opportunities for improvement of the medication-use system. Objective 2.1.4: Participate in medication event reporting and monitoring. Goal R2.2: Demonstrate ability to evaluate and investigate practice, review data, and assimilate scientific evidence to improve patient care and/or the medication use system. Objective R2.2.1: Identify changes needed to improve patient care and/or the medication-use systems. Objective R2.2.2: Develop a plan to improve the patient care and/or medication-use system. Objective R2.2.3: Implement changes to improve patient care and/or the medication-use system. Objective R2.2.4: Assess changes made to improve patient care or the medication-use system. Objective R2.2.5: Effectively develop and present, orally and in writing, a final project report. 3
Competency Area R3: Leadership and Management Goal R3.1: Demonstrate leadership skills. Objective R3.1.1: Demonstrate personal, interpersonal, and teamwork skills critical for effective leadership. Objective R3.1.2: Apply a process of on-going self-evaluation and personal performance improvement. Goal R3.2: Demonstrate management skills. Objective R3.2.1: Explain factors that influence departmental planning. Objective R3.2.2 Explain the elements of the pharmacy enterprise and their relationship to the healthcare system. Objective R3.2.3: Contribute to departmental management. Objective R3.2.4: Manage one s own practice effectively. Competency Area R4: Teaching, Education, and Dissemination of Knowledge Goal R4.1: Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups). Objective R4.1.1: Design effective educational activities. Objective R4.1.2: Use effective presentation and teaching skills to deliver education. Objective R4.1.3: se effective written communication to disseminate knowledge. Objective R4.1.4: Appropriately assess effectiveness of education. Goal R4.2: Effectively employ appropriate preceptors roles when engaged in teaching (e.g., students, pharmacy technicians, or other health care professionals). Objective R4.2.1: When engaged in teaching, select a preceptors role that meets learners educational needs. Objective R4.2.2: Effectively employ preceptor roles, as appropriate. Competency Area E1: Pharmacy Research Goal E1.1 Conduct and analyze results of pharmacy research. Objective E1.1.1: Design, execute, and report results of investigations of pharmacy-related issues. Competency Area E5: Management of Medical Emergencies Goal E5.1 Participate in the management of medical emergencies. Objective E5.1.1: Exercise skill as a team member in the management of medical emergencies according to the organization s policies and procedures. Competency Area E6: Teaching and Learning Goal E6.1 Demonstrate foundational knowledge of teaching, learning, and assessment in healthcare education. Objective E6.1.1: Explain strategies and interventions for teaching, learning, and assessment in healthcare education. Objective E6.1.2: Explain academic roles and associated issues. Goal E6.2 Develops and practices a philosophy of teaching. Objective E6.2.1: Develop a teaching philosophy statement. Objective E6.2.2: Prepare a practice-based teaching activity. Objective E6.2.3: Deliver a practice-based educational activity, including didactic or experiential teaching, or facilitation. Objective E6.2.4: Effectively document one s teaching philosophy, skills, and experiences in a teaching portfolio. 4
Beth Israel Deaconess Medical Center PGY1 Pharmacy Residency Program 2017-18 Administration and Governance Katherine Cunningham, PharmD, MHA, BCPS Director of Clinical Pharmacy Programs Residency Program Director Beth Israel Deaconess Medical Center 617.754.3812 kcunning@bidmc.harvard.edu Beth Israel Deaconess Medical Center: May Adra, PharmD Clinical Coordinator, Medication Safety Beth Israel Deaconess Medical Center 617.754.3822 madra@bidmc.harvard.edu Katelyn Richards, PharmD, BCPS Clinical Pharmacist, Solid Organ Transplant Beth Israel Deaconess Medical Center 617.754.3859 krrichar@bidmc.harvard.edu Monica Mahoney, PharmD, BCPS Clinical Coordinator, Infectious Diseases Beth Israel Deaconess Medical Center 617.754.3822 mgolik@bidmc.harvard.edu Christin Rogers, PharmD, BCPS Clinical Coordinator, Solid Organ Transplant Beth Israel Deaconess Medical Center 617.754.3823 crogers3@bidmc.harvard.edu John Marshall, PharmD, BCPS Clinical Coordinator, Critical Care Beth Israel Deaconess Medical Center 617.754.3854 jmarshal@bidmc.harvard.edu Christopher McCoy, PharmD, BCPS Clinical Coordinator, Antibiotic Stewardship Beth Israel Deaconess Medical Center 617.754.3817 cmccoy@bidmc.harvard.edu Morgan Smith, PharmD, BCOP Clinical Coordinator - Hematology/Oncology Beth Israel Deaconess Medical Center 617.754.3855 msmith32@bidmc.harvard.edu Diane Soulliard, PharmD, BCPS Clinical Coordinator, Education/Training Beth Israel Deaconess Medical Center 617.754.3828 dsoullia@bidmc.harvard.edu MCPHS University Michael Carvalho,BS, Pharm.D., BCPP Professor and Chair, Department of Pharmacy Practice, Assistant Dean of Interprofessional Education, Pharmacy Practice MCPHS University 179 Longwood Avenue Boston, MA 02115 michael.carvalho@mcphs.edu Caroline Zeind, PharmD, RPh Associate Provost for Academic and International Affairs, Chief Academic Officer Worcester/Manchester, Academic Affairs MCPHS University 19 Foster Street Worcester, MA 01608 508.373.5825 Caroline.Zeind@mcphs.edu 5
BIDMC Residency Advisory Committee (RAC) The Residency Advisory Committee governs the residency program. The committee is comprised of preceptors and members of the Pharmacy Administrative Group. The Committee is chaired by the Residency Program Director and meets at least monthly to review and discuss the progress of the residents. Interactive feedback within the committee is utilized to direct the resident in his/her current and upcoming residency activities and to provide mentoring and guidance in the resident s pharmacy practice. The committee will recommend modifications to the residents schedule as necessary. Each member of the RAC is expected to: Act as an advocate for the resident. Provide expertise for the residency project (when possible) or identify other appropriate resources Provide feedback and suggestions on improving current rotation sites, as well as identifying future potential rotation sites Provide feedback and suggestions on the current structure of the residency program, and offer possibilities for future direction PGY 1 Pharmacy Resident Advisor Mentoring and advising are key elements of the BIDMC PGY1 Pharmacy Residency Program. The Residency Advisory Committee governs the residency program and is designed so that the resident will be afforded the opportunity to meet regularly with the committee members at large to discuss and receive feedback on their progress within the residency program and address any issues or concerns that may arise. To provide the resident with the opportunity for individualized mentoring and advising, the RAC will work with each incoming resident to coordinate the selection of an individual Resident Advisor for the academic year. The principle role of the Resident Advisor is to act as a personal contact for the resident in all matters dealing with the successful completion of the PGY1 residency program. The Resident Advisor will work with the resident to develop their residency plan and will monitor the plan s progress. The resident and advisor will collaborate and determine the degree of contact and involvement necessary to meet these objectives. Key areas that will be focused on include: advice on projects (initiation, completion, deadlines etc.), elective rotation selection, time management, professional interpersonal relationships and conflict, career opportunities after residency and any other residency-related issues that may arise. The Resident Advisor will collaborate with the RPD to complete the resident s quarterly assessments. Determination of a Resident Advisor will be made in alignment with the determination of the resident project. In general, the project advisor works closely with the resident throughout the year and is the most appropriate RAC member to fulfill the mentoring and advising role that is central to the Resident Advisor position. Should circumstances during the residency year warrant reevaluation of the selection of a resident s advisor, discussion with and approval by the RPD will be required before any changes are made. PGY 1 Pharmacy Resident Staff Mentors Partnering with a staff mentor is intended to provide the resident with a support system as they transition into their role as a pharmacist in the department and the medical center at large. Staff mentors will assist in answering the resident s questions and providing professional and personal guidance and feedback to the resident throughout the year. 6
Core Rotations (5 weeks- 5 required ) Hematology/Stem Cell Transplant (BMT) Medical Intensive Care Oncology (Inpatient) Infectious Diseases Internal Medicine Solid Organ Transplant Teaching Rotation: MCPHS Internal Medicine APEP Core Elective Rotations (4 weeks: 3 Required) Advanced Medical Intensive Care Cardiology Disease Specific Ambulatory Clinics Hepatology Infectious Diseases: Antibiotic Stewardship Infectious Diseases Consult Service-Advanced Elective Medication Safety Neuro/Surgical Intensive Care Trauma Intensive Care Required Longitudinal Learning Experiences Pharmacy Management/Leadership/Safety Formulary/Leadership/Project Management Medication Safety /Quality Assurance Pharmacy Services Resident Report Pharmacy Orientation/Training BIDMC PGY1 Pharmacy Residency Program Structure 2017-18 Staffing: One evening / wk, one weekend/ mo Code Response Training/Participation Preceptor Morgan Smith, PharmD, BCOP John Marshall, PharmD, BCPS; Mary Eche, PharmD Morgan Smith, PharmD, BCOP Monica Mahoney, PharmD, BCPS Alexa Carlson, PharmD, BCPS; Margarita Divall, PharmD, BCPS Christin Rogers, PharmD, BCPS; Katelyn Richards, PharmD, BCPS Snehal Bhatt, PharmD, BCPS Preceptor John Marshall, PharmD, BCPS Snehal Bhatt, PharmD, BCPS TBD Katelyn Richards, PharmD, BCPS Christopher McCoy, PharmD, BCPS Monica Mahoney, PharmD, BCPS May Adra, PharmD, BCPS Natalya Asipenko, PharmD, BCPS John Marshall, PharmD, BCPS Preceptor Katherine Cunningham, PharmD, BCPS; Pharmacy Administration Team May Adra, PharmD, BCPS Diane Soulliard, PharmD/ Christopher Peric, PharmD Christopher Peric, PharmD/ Diane Soulliard. PharmD Diane Soulliard, PharmD,/John Marshall, PharmD Residency Advisor Committee Members Teaching Facilitate MCPHS Therapeutics Seminar MCPHS University Resident Teaching Certificate Program (RTCP) Interdisciplinary Management and Communication Participate in P&T Committee meetings (2) Attend Administrative Leadership Meeting (1) Participate in Medication Safety Meeting/s (1) Participation in Departmental and Rotation- Coordinated Hospital Committee Meetings Drug Information / Communication Drug Information Questions Journal Club Eastern States Research Project Presentation ASHP Midyear Poster Presentation Continuing Education Presentations (1) Residency Projects MUE Residency Research Project Eastern States and MCPHS Presentations P&T/Clinical Division Presentations Snehal Bhatt, PharmD, BCPS MCPHS Faculty Katherine Cunningham, PharmD, BCPS Katherine Cunningham, PharmD, BCPS May Adra, PharmD, BCPS Residency Preceptor Residency preceptor (DI aligns with resident report/ rotations) Residency preceptor (aligns with resident report/ rotations) Residency preceptor/ K.Cunningham, PharmD, BCPS Residency preceptor/ K.Cunningham, PharmD, BCPS Residency Preceptor/s, RPD 7
BIDMC PGY1 Residency Program Requirements 2017-18 Successful completion of the BIDMC PGY1 Residency Program requires the achievement of the required ASHP Residency Program Residency Learning System Outcomes, Goals and Objectives. Each resident is required to achieve all required and selected elective residency goals by the end of the residency year. Progress towards achieving these goals will be monitored at least quarterly by the Resident Advisor in conjunction with the RPD. The following are detailed descriptions of required activities: 1. Participation in Residency Orientation/Training Program: Start of Residency A formal orientation program for all residents is scheduled in July of each year. All new residents are expected to attend these sessions. This orientation period is to introduce the incoming residents to the BIDMC Department of Pharmacy, the BIDMC Medical Center at large, MCPHS University; and to outline the expectations for the residency year. 2. Department of Pharmacy Practice-Service: July 1st June 30 th Each resident is required to complete a pharmacy service component of the residency program. Often referred to as "staffing," the service component of the residency is crucial to the development of professional practice and distribution skills so as to provide safe and effective pharmaceutical care. Residents will gain insight into the operations, policies and procedures of an acute-care facility. 3. Rotations- Core and Elective: July 1st - June 30 th Each resident is responsible to complete a defined number of core clinical and management rotations as well as a determined number of elective rotations. Rotations will be evaluated using the PharmAcademic web-based software tool. One week prior to each rotation, the resident will submit their pre-rotation goals in PharmAcademic so as to provide an opportunity for the preceptor to evaluate, and if possible, to design specific activities to meet the resident s goals. At the beginning of each rotation, the preceptor will provide residents with the rotation: goals and objectives, learning activities and method of evaluation. Residents are responsible for coordinating their evaluations with the rotation preceptor. Rotation evaluations should be scheduled during the last week of rotation and are to be completed no later than one week following the conclusion of the rotation. Copies of the evaluation will be maintained in the resident s portfolio. 4. Medication Use Evaluation: TBD (per MUE Advisor) Each resident is required to participate in and complete a Medication Use Evaluation (MUE). Topics may be pertaining to direct patient care, quality improvement; fiscal oversight or others. 5. Residency Project: Longitudinal Each resident is responsible for the completion of residency project. The project may be in the form of original research, a problem-solving exercise, or development, enhancement or evaluation of some aspect of pharmacy operations or patient care services. As a component of the project, the resident will submit the project as a work in progress for poster presentation at the ASHP Midyear Meeting. Each resident will complete a project report using an accepted manuscript style suitable for publication in the professional literature. 6. Participation in Departmental and External Leadership Activities: Longitudinal A number of activities and opportunities for leadership development will be scheduled throughout the residency year to foster an understanding of leadership within the department of pharmacy, within the profession of pharmacy and within the field of healthcare. 8
7. Participation in Drug Information Services: Longitudinal Each resident will participate in several venues to provide drug information, which include but are not limited to Drug Information Questions, Development/update of PPGD, P & T Committee Formulary Reviews, Journal Club and other drug information activities, etc. The goal of these activities is to provide the resident with experience in the provision of pertinent drug information in a number of venues. 8. Presentation of a Pharmacy CE (In-Service Program): Date TBD Each resident will present one approved continuing education (CE) in-service during the residency program. The topic and presentation schedule will be developed in coordination with the Residency director and approved by the Residency Advisory Committee. The goal of the inservice is to improve the resident's communication skills and techniques, literature evaluation, and understanding of the continuing education process. 9. Participation in Teaching Activities: TBD per MCPHS University calendar Resident involvement in the teaching activities fosters clinical development and refinement of the resident's teaching and communication skills. The residents will serve as preceptors to MCPHS University students during their 6 week Advanced Pharmacy Practice Experience. The residents will be responsible for developing the rotation goals and objectives for the students as well as coordinating all on-site activities and evaluations. The resident will actively participate as a facilitator for MCPHS University Therapeutics Seminar. The resident will participate in the longitudinal MCPHS University Teaching Certificate Program. Additional teaching activities may be assigned at the discretion of the residency director and MCPHS University Coordinator. 10. Participation in Recruitment Efforts: November 2017-March 2018 Each resident will assist with the new resident recruitment efforts of the department. Because each resident is an important source of information and advice for potential candidates, there will be scheduled time within the interview process for interviewees to interact with current residents. Additionally, each resident is required to spend time providing information to interested parties during the Boston Residency Showcase and the ASHP Midyear Clinical Meeting Residency Showcase. 11. Attendance/Podium Presentation- Eastern States Residency Conference: May 2018 The Eastern States Residency Conference is held in the spring of the year (generally in early May) and is a forum where residents share experiences and expertise. Each resident will make a presentation on his or her residency project, which will be evaluated by the Residency Director and/ or coordinating preceptor. Residents will also be reviewed by their peers and other preceptors attending the program 12. Participation in Resident Advisory Council (RAC) Meetings: Longitudinal Residents will attend scheduled RAC meetings to discuss upcoming resident events, other issues pertaining to the residency program, and actions/recommendations made at residency committee meetings, etc. Meetings will be scheduled by the Director of the Residency Program. 9
BIDMC PGY1 Pharmacy Residency Program 2017-18 Qualification of the Resident: Qualifications for participation in the BIDMC PGY1 Residency Program are in accordance with criteria set forth by the American Society of Health System Pharmacists (ASHP). Residents must be graduates or candidates for graduation of an Accreditation Council for Pharmacy Education (ACPE) accredited degree program (or one in process of pursuing accreditation) or have a Foreign Pharmacy Graduate Equivalency Committee (FPGEC) certificate from the National Association of Boards of Pharmacy (NABP). Residents must be licensed or eligible for licensure in order to be licensed in MA within 90 days of the commencement of the residency. Residents must be authorized to work in the United States on a full-time basis. Work authorization sponsorship for this position is unavailable. Residents shall participate in and obey the rules of the Residency Matching Program. Application to the BIDMC Residency Program: Applicants to the BIDMC Residency Program will complete an electronic application in Phorcas and submit by the application deadline. Materials to be included are: A one-page letter of Intent including a statement of professional goals and reasons for pursuing the PGY1 Residency Curriculum Vitae Three Letters of Recommendation Official transcript from accredited School/College of Pharmacy Selection of Applicants for an On-Site Interview Members of the BIDMC RAC will utilize a program specific applicant selection rubric to review and determine a score for each application to the program. The letter of intent, CV, scholastic record and letters of recommendation weigh highly in the review process. We also consider work experience, career goals, leadership activities, teaching experience and involvement in professional activities as important factors in our selection process. In determining the candidates for on-site interviews, input from the RAC may be used to adjust the calculated application rank score. The RPD will utilize this information to make the final decision in determining applicants that most closely match the BIDMC PGY1 program goals and opportunities at the medical center. Selected applicants will receive an e-mail of interview interest from the RPD. A predetermined list of interview dates will be sent to the candidates, and interview slots will be filled on a first-come-first-serve basis. Interview Process Selected candidates will be interviewed on-site and evaluated utilizing a standardized evaluation and scoring tool. The RAC will meet to review the calculated interview scores and determine the final rank list. The BIDMC RAC reserves the right to adjust the rank list based on discussion and consensus of which applicants most closely match the program goals and opportunities at the medical center. A rank list will be submitted to the ASHP Residency Matching Program Acknowledgement of Residency Match: Residents matched to the BIDMC Residency program will receive an acceptance letter acknowledging the match and delineating the general terms and conditions of the residency. Acknowledgment in writing by the resident will constitute acceptance of the match and agreement to fulfill the duties of the residency position for the upcoming year. 10
Pharmacy Licensure Requirements and Verification: In alignment with the ASHP Standards for Accreditation of PGY1Residency Programs which require that a minimum of 2/3 of the residency (8 months) is completed as a pharmacist licensed to practice in the program s jurisdiction; participation in the BIDMC PGY1 Residency Program is contingent on securing and maintaining a license without restriction in the Commonwealth of Massachusetts (MA). If a PGY1 Resident is not licensed prior to the start of the BIDMC PGY1 Residency program, the residents must obtain a MA pharmacy intern license, which they will practice under, until they pass the required examinations and receive notification that they are licensed as a pharmacist in MA. Residents are expected to be licensed as a pharmacist with the MA Board of Pharmacy within 90 days of the start their residency program. The resident will communicate with the RPD the status of their progress in attaining licensure and confirmation of licensure once notified by the MA Board of Pharmacy. Residents must contact the RPD prior to these deadlines should any issues or extenuating circumstances arise with obtaining licensure. Failure to obtain licensure by 90 days from the start of the residency is grounds for dismissal from the program. Should a resident not attain licensure within the 90 days, consideration may be given to extend this deadline on a case by case basis if the resident is progressing in the program appropriately, has no documented corrective action/s and can be licensed within the next 30 days. Residents who have not attained MA licensure by 120 days of the start of the residency will be dismissed from the program. 11
BIDMC PGY1 Pharmacy Residency Program 2017-18 Obligations of the Program to the Resident The PGY1 residency at BIDMC provides a 12-month advanced education and training experience for the Pharmacy Resident. It is the intent of the pharmacy residency program to provide an exemplary environment conducive to resident learning. Program Competencies, Goals and Objectives for the BIDMC PGY1 program are in alignment with the ASHP PGY1 Residency required standards. Activities taught and evaluated throughout the program are intended to assure the desired outcomes are achieved through structured learning experiences. Individualized Resident Plan Flexibility has been built into the program to allow the resident to select learning experiences to meet their interests and to focus on identified areas for improvement. A customized residency plan will be designed and updated during the program for each resident based upon these criteria. BIDMC PGYI Pharmacy Residency Evaluations An essential component of developing the skills of a resident and continuous improvement to the residency program is frequent two-way feedback between residents and preceptors. The goal of such discussion and interaction is to: Discuss the resident's achievements in terms of learning objectives established for the rotation Provide feedback that may assist the resident with future rotations or practice Provide feedback to the preceptors for continuous improvement of preceptor skills, that may strengthen mentoring during future rotations Provide feedback to the coordinator, in order to improve the residency program, and coordinator skills. The preceptors, program director, and residents will frequently provide feedback to one another during individual rotations, resident activities and in general throughout the residency program. Specific program and rotation feedback may be given via different formats depending upon the learning experience. This will include both oral and written feedback and evaluation. Evaluations will occur as described below: 1. Resident Self-Evaluation: Self-assessment and evaluation is an important component of the learning experience for the resident. For each rotation, the resident will complete pre-rotation goals in PharmAcademic prior to the start of the learning experience. It is the expectation that these goals will provide a focus for self-directed learning for the resident and will assist the preceptor in preparing an individualized plan for the resident. At the conclusion of the rotation/ learning experience, the resident will complete a summative self-evaluation of their progress and attainment in meeting the goals and objectives of that rotation in PharmAcademic. Quarterly self-evaluations by the resident should be submitted to the Resident Advisor one week prior to the scheduled review date with the Advisor. 2. Rotation Summative Evaluations: At the end of each rotation, in addition to the resident s summative self-evaluation of his/her performance during that rotation, residents will also complete a preceptor and learning experience summative evaluation in PharmAcademic. Rotation preceptors will utilize PharmAcademic to complete an independent criteria-based, summative assessment of the resident s performance for each of the respective rotation-selected educational goals and objectives assigned to the learning experience. The resident and preceptor will meet to review and discuss these evaluations together. 12
3. Criteria Based Assessments: Rotation preceptors will provide periodic opportunities for the resident to practice and document criteriabased, formative self-evaluation of aspects of their routine performance and to document criteria-based, summative self-assessments (snap-shots) of achievement of the educational goals and objectives assigned to the learning experience. Feedback and evaluation of such selected activities will be conducted throughout the residency for both rotation and longitudinal activities. These will include but is not limited to: Case Discussion (Primary preceptor during that experience) Communication (Primary preceptor during that experience/advisor/rpd) Intervention Documentation (Primary preceptor during that experience/advisor) Problem solving (Primary preceptor during that experience/advisor) Researched DI Questions (Primary preceptor during that experience) Journal Club (Primary preceptor during that experience/pharmacy staff /students) Other project assignments(evaluation preceptor will be assigned) 4. Quarterly Evaluations: These are longitudinal evaluations providing written evaluation of the resident s progress within the residency program. The quarterly evaluation will address progress towards the resident s individual residency goals and objectives as well as the required and longitudinal activities of the program. The resident will complete a quarterly self-assessment and submit this to his/her Resident Advisor one week prior to the scheduled Quarterly Evaluation meeting time with the advisor. Following the review and discussion of the quarterly evaluation between the resident and his/her Advisor, a meeting with the RPD will be scheduled to discuss the resident s overall progress and to complete the quarterly update of the resident s customized plan. 5. Residency Advisory Committee Assessments: Immediate feedback on specific topics/issues is provided during each RAC meeting. Throughout the residency year, the resident will seek feedback on various assignments, presentations, drug information questions, project work and other activities. Assessment by committee members will be provided in a number of formats, each contributing to the progress of the resident in achieving his/her residency goals. 6. Custom Evaluations: Some residency experiences will be evaluated utilizing custom evaluations that are not in PharmAcademic. Resident s should maintain a copy of each evaluation and these should be filed by the resident in his/her Residency Portfolio Evaluation scale definitions to be utilized in the summative rotation and quarterly evaluations: 5- Major Strength [Excellent]: Resident consistently demonstrates high level of performance for evaluated skill, ability, initiative, or productivity. All associated assignments/responsibilities are completed above the level of expectation. 4- Solid Performance [Very Good]: Resident demonstrates high level of performance for evaluated skill, ability, initiative, or productivity; exceeding requirements in some areas, but not consistently or not without exception. Resident is capable of independent performance the majority of the time with only minimal preceptor intervention. 3- Developing: [Satisfactory] Resident displays an understanding of evaluated skill, ability, initiative, or productivity, however he/she requires additional work to develop and sustain an effective level of performance for the evaluated skill, ability, initiative, or productivity. Resident needs occasional preceptor intervention. 2- Needs Improvement: Resident displays inconsistency in the performance of the evaluated skill, ability, initiative, or productivity review and performance frequently falls below acceptable levels. Frequent preceptor intervention is needed and development is required to meet expected performance level. 1- Unsatisfactory: Resident s performance is consistently below expectations, and/or he/she has failed to make reasonable progress toward agreed upon expectations and goals. Significant improvement is needed in most aspects of their performance. (A plan to improve performance with specified timelines must be outlined and monitored for improvement.) 7. At least 75% of a Resident s monthly or quarterly evaluations should be scored at 3-5 in order to successfully complete the residency program. An objective will be marked Achieved (ACH) at the discretion of the Residency Director and preceptors. Typically, this will be considered when a resident has scored two or more scores 4 for that objective. 8. The Resident must achieve the required ASHP goals and objectives for successful completion of the program. 13
Residency Preceptors In alignment with accreditation and practice standards set forth by ASHP, the BIDMC PGY1 residency program is committed to provide residency training precepted by qualified pharmacists. Criteria regarding the required minimum qualifications of preceptors include: Preceptors must be licensed pharmacists, and: Have completed an ASHP-accredited PGY1 residency followed by a minimum of one year of pharmacy practice experience; or, Have completed an ASHP-accredited PGY1 residency followed by an ASHP-accredited PGY2 residency and a minimum of six months of pharmacy practice experience; or, Without completion of an ASHP-accredited residency, have three or more years of pharmacy practice experience The ASHP Accreditation Standards outline the responsibilities of preceptors necessary for accreditation compliance, stating that preceptors serve as role models for learning experiences and they must: Contribute to the success of residents and the program; Provide learning experiences in accordance with the standards; Participate actively in the residency program s continuous quality improvement processes; Demonstrate practice expertise, preceptor skills, and strive to continuously improve; Adhere to residency program and department policies pertaining to residents and services; and, Demonstrate commitment to advancing the residency program and pharmacy services In addition to aforementioned requirements, the following Preceptors Qualifications are essential prerequisites for ASHP Residency Preceptors. Preceptors must demonstrate the ability to precept residents learning experiences as described in the following areas: Demonstrate the ability to precept residents learning experiences by use of clinical teaching roles (i.e., instructing, modeling, coaching, facilitating) at the level required by residents; Demonstrate the ability to assess residents performance; Demonstrate recognition in the area of pharmacy practice for which they serve as preceptors; Maintain an established, active practice in the area for which they serve as preceptor; Maintain a continuity of practice during the time of residents learning experiences; and, Demonstrate ongoing professionalism, including a personal commitment to advancing the profession. To ensure ongoing reflection and personal profession development in meeting the requirements of a qualified preceptor, a Preceptor Self-Assessment tool has been developed and will be completed annually by each preceptor. The RPD will utilize this information, in addition to the rotation preceptor evaluations to determine individual and program needs for preceptor development. Select learning experiences in later stages of the residency, (when the primary role of the preceptor is to facilitate resident learning experiences), may be precepted by practitioners who are not pharmacists (e.g., physicians, physician assistants, and certified nurse practitioners.) In these instances, a pharmacist preceptor will work closely with the non-pharmacist preceptor to select the educational goals and objectives as well as participate actively in the criteria-based evaluation of the resident s performance. Such learning experiences will be conducted only at a point in the residency when the RPD and preceptors agree that the resident is ready for independent practice. Evaluations conducted at the end of previous learning experiences will reflect such readiness to practice independently. 14
Preceptor and Program Development Plan The Residency Program Director evaluates the qualifications of potential preceptors and re-evaluates current preceptors based on the ASHP Accreditation Standard for PGY1 Pharmacy Practice Residency Programs. In addition to the RPD evaluation, all residency preceptors and preceptors in training will complete an annual self-assessment survey to evaluate their practice and precepting skills. Based on these evaluations and self-assessments, the RPD will coordinate with the RAC to select and provide preceptors with opportunities to develop and enhance their precepting skills during the residency year. Select Residency Advisory Committee Meetings, the Annual Preceptor Retreat and specific educational programs will be utilized to schedule preceptor development activities. To complement the preceptor development programs and activities conducted at BIDMC, a wide number of Preceptor Development resources are available online and can be utilized by preceptors for their personal development. Examples include: Pharmacist Letter Preceptor Home: http://www.pharmacistsletter.com (on-line access through the schools of pharmacy) American Society of Health Systems Pharmacist (ASHP): www.ashp.org Precepting tools though the Colleges of Pharmacy (e.g. Preceptors for NEU and have e-value access and access to the Collaborative Education Institute) To foster ongoing individual preceptor development, the RPD will review and provide feedback on the preceptor's rotation summaries as well as the preceptor evaluations. Preceptors will be committed to selfreflection and will make active use of feedback provided to them so as to promote continual improvement of their rotations and precepting skills. Issues identified by the RPD in any of these evaluations will be addressed by the RPD with the persons involved. Action steps and corrective actions will be identified and implemented on an as needed basis. At least annually, the RPD in collaboration with members of the Residency Advisory Committee will consider overall program changes based on evaluations, observations, and other information. New Preceptors and Preceptors in Training Clinical Pharmacists who wish to become preceptors should submit their intent for consideration to the Residency Program Director (RPD). Based upon their academic and professional record, the RPD will determine if they meet the ASHP standards for qualifications of a residency preceptor or if they will be considered a preceptor-in-training while attaining the required qualifications. Preceptors-in-training will be assigned a mentor who is a qualified preceptor; and, will have a documented preceptor development plan to meet the qualifications for becoming a residency preceptor within two years. The preceptor candidate will maintain and submit all of the following records for consideration: Completed annual preceptor-self assessment form Review of the current residency program manual Review of the PharmAcademic preceptor training slides RAC meeting attendance record Preceptor development continuing education training program/s Co-preceptorship activities 15
Beth Israel Deaconess Medical Center PGY1 Pharmacy Residency Program 2017-18 Expectations and Responsibilities of Residents Professional Practice: Professional Conduct: It is the responsibility and expectation of all Residents participating in the BIDMC Residency to maintain the highest degree of professional conduct at all times. The resident will display an attitude of professionalism in all aspects of his/her daily practice. Professional Dress: All residents are expected to dress in an appropriate professional manner whenever they are within the Medical Center or participating in or attending any function as a representative of the BIDMC or MCPHS University. A detailed policy is found in the BIDMC Department of Pharmacy Policies and Procedures. It is the expectation that the resident will wear a clean, pressed white lab coat at all times in patient care areas. Employee Badges: BIDMC requires all personnel (including residents) to wear his/her badge at all times when they are within the medical center. Badges will be obtained from the BIDMC Security office during Orientation. If the employee badge is lost the resident must report the loss immediately to Security, and render a fee for replacement. Communication: The resident is responsible for promoting good communication between the pharmacists, patients, physicians, and other health care professionals. The resident shall abide by the BIDMC hospital policies regarding the use of hospital and cellular phone within the hospital and in patient care areas. Constructive criticism is a means of learning and is not meant to embarrass. Any conflicts which may arise between the candidate and preceptor should first be handled by discussing it with one another. If resolution is not achieved, then discussing the situation with the Residency Program Director is the next appropriate step to achieve resolution. Patient Confidentiality: Patient confidentiality will be strictly maintained by all residents. Time for completion of HIPPA training will be scheduled during pharmacy practice training. It is the expectation that residents will not discuss patientspecific information with other patients, family members or other person not directly involved in the care of the patient. Similarly, residents will not discuss patients in front of other patients or in areas where people may overhear. Residents will not leave confidential documents (profiles, charts, prescriptions, etc.) in public places. Residents should understand that inappropriate conduct (e.g., breach of confidentiality) may result in disciplinary action. Attendance: Residents are expected to attend all functions as required by the Residency Advisory Committee, the Residency Program Director and rotation preceptors. The residents are solely responsible for meeting the obligations of their assigned service commitments (staffing). Specific hours of attendance will be delineated by each preceptor in accordance to the individual rotation requirements. 16
Duty Hour policies: Beth Israel Deaconess Medical Center PGY1 Pharmacy Residency Program 2017-18 Standards have been established by the Accreditation Standard for Pharmacy Residencies regarding the time residents spend performing patient care duties and other activities related to their program. (http://www.ashp.org/doclibrary/accreditation/regulations-standards/duty-hours.aspx) It is recognized that providing residents with a sound didactic and clinical education must be carefully planned and balanced with concerns for patient safety and resident well-being. The BIDMC Residency Program is structured so that the learning objectives of the program are not compromised by excessive reliance on residents to fulfill service obligations and that didactic and clinical education have priority in the allotment of residents time and energy. Duty hours are defined as all scheduled clinical and academic activities related to the pharmacy residency program. This includes inpatient and outpatient care, in-house call, administrative duties, scheduled and assigned activities, such as conferences, committee meetings, and health fairs that are required to meet the goals and objectives of the residency program. Duty hours must be addressed by a well-documented, structured process. Duty hours do not include: reading, studying, and academic preparation time for presentations, journal clubs; or travel time to and from conferences; and hours that are not scheduled by the residency program director or preceptor. Duty hours must be limited to 80 hours per week, averaged over a four-week period, inclusive of all in-house call activities and all moonlighting. Mandatory time free of duty: residents must have a minimum of one day in seven days free of duty (when averaged over four weeks). At-home call cannot be assigned on these free days. Residents should have 10 hours free of duty between scheduled duties, and must have at a minimum 8 hours between scheduled duty periods. Continuous duty periods of residents should not exceed 16 hours. The maximum allowable duty assignment must not exceed 24 hours even with built in strategic napping or other strategies to reduce fatigue and sleep deprivation, with an additional period of up to two hours permitted for transitions of care or educational activities. External Employment Policy (Moonlighting) Successful completion of the residency program leading to certification is a function of the successful completion of all the program's requirements, which determine the primary schedule of the resident. It must be understood that he responsibilities of the resident may not correspond to a consistent day to day schedule and at times, extra hours of coverage may be necessary to complete residency requirements. Patient-care rotations, teaching, and service requirements take precedence over scheduling for external employment and thus, the residency program is considered the primary priority of each resident. External employment, if desired, may not interfere with the resident s responsibilities or requirements. All additional shifts to be picked up by the resident require approval by the current rotation preceptor as well as the Residency Director. There is a provision regarding employment at BIDMC to work as a pharmacist should additional staffing hours be available. Working additional hours for BIDMC is considered outside employment and as specified, must not interfere with the activities of the residency program, nor conflict with the Duty Hours Policy. 17